阻塞性睡眠呼吸暂停低通气综合征对心血管危险因素的影响

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)在心血管疾病发病中的作用。方法将2007年1月~2008年12月在呼吸睡眠监测中心就诊的成年患者,进行多导睡眠图(PSG)检测,根据睡眠呼吸暂停低通气指数(AHI)将所有对象分为轻度组(AHI为5~20次/h)、中度组(AHI为21~40次/h)、重度组(AHI大于40次/h)和健康对照组(AHI小于5次/h);全自动生化仪检测血清胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、载脂蛋白A-I、载脂蛋白B、脂蛋白a;ELISA法检测患者外周血清C反应蛋白。结果所有入选对象M型超声心动图检测结果均在正常范围内。血脂检测显示:①HDL-C、载脂蛋白A-I在OSAHS组和对照组间比较无统计学意义;②脂蛋白a、载脂蛋白B水平在OSASH各组间比较无统计学意义,但均高于对照组(P均小于0.05);③与对照组相比,OSAHS患者的甘油三酯和LDL-C水平明显升高(P<0.05),重度组明显高于轻中度组(P<0.05),轻中度组间差异无统计学意义(P>0.05);④与健康对照组相比,OSAHS患者的外周血总胆固醇水平显著升高,并随着OSAHS病情加重呈升高趋势,差异均有统计学意义(P<0.05)。OSAHS患者外周血清C反应蛋白水平明显高于健康对照组,并且随着病情加重逐渐上升,差异均有统计学意义(P<0.05)。结论OSAHS可引起患者血清C反应蛋白和血脂升高,导致OSAHS患者心血管疾病的发病率和死亡率上升,这将为临床上心血管疾病的早期诊断和OSAHS的治疗提供新思路。

Influence of Obstructive Sleep Apnea hypopnea Syndrome on Cardiovascular Risk Factors

Objectives The aims of this study were to determine whether OSAHS is associated with serum cardiac risk markers and to investigate the relationship between them.Methods Ninety-one male patients were classified into three groups with respect to apnea-hypopnea index(AHI): slight group(n=23) with 5≤AHI≤20,medium group(n=32) with 2040,and control group(n=22) with AHI≤5.We compared cardiovascular risk factors in three groups with control subjects without OSAHS.Serum cholesterol,triglyceride,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A-I,apolipoprotein B,lipoprotein(a),and C-reactive protein(CRP) were measured.Statistical significance was assessed with analysis of variance at P<0.05.Results All of the M-mode echocardiographic parameters were in the normal reference range.① There was no significant difference between OSAHS group and control group in HDL-C and apolipoprotein A-I.② OSAHS group was significantly higher than control group in apolipoprotein B and lipoprotein(a)(P<0.05),but therewasnosignificantlydifferenceamongthreeOSAHSgroups.③ Higher levels of triglyceride and LDL-C were detected in OSAHS group compared with control group(P<0.05),and those in severe group compared with other two groups as well(P<0.05).④ Serum cholesterol levels were markedly increased from slight to servere OSAHS group(P<0.05),and so were those in OSAHS group compared with control group as well(P<0.05).Serum CRP values were increased in three OSAHS groups when compared with control subjects(P<0.05).Higher CRP levels were determined in OSAHS group compared to control group(P<0.05),and serum CRP levels were significantly increased from slight group to severe group.Conclusions Our results show that OSAHS syndrome is associated with increased CRP concentrations and hyperlipidemia.OSAHS is associated with increased risks for cardiovascular morbidity and mortality.Increased plasma concentrations of CRP and hyperlipidemia can be useful in clinical practice as predictor of long-term prognosis for cardiovascular disease and the treatment of OSAHS.